Sensory Processing in Occupational Therapy

Hi my name is Crystal and I’m Kelsey, we’re both occupational therapist here at Therapy Playground. We both treat many kids with sensory processing disorder, dysfunction, or deficit. And we realize that a lot of our kids, or parents, don’t even know what sensory processing is, or if they know it they know very little.

So today we’ve created this podcast for you to hopefully give you some insight to what sensory processing disorder, dysfunction, or deficit is. So we’re going to answer a couple of questions. Our first question that we’d like to answer for you is, is sensory processing disorder a diagnosis? And the answer is actually confusing, it is yes and no. It used to be a diagnosis for everyone, and you could get it formally by a psychologist, however, now only ages zero to 3 can be formally diagnosed, so you can no longer get the formal diagnosis (if you’re over 3). So you could have gotten it in the past, but now there’s not a formal diagnosis for it.

The second question is, many people will ask because there isn’t a formal diagnosis, can my child still be treated without a formal diagnosis? And the answer is yes. So what you would do is come to an occupational therapy evaluation and you would be evaluated by an occupational therapist, and they would do a client or caregiver survey which they measure on the computer or profile through clinical observation to make sure or to see what is going on with your child if they’re having any difficulties or deficits with sensory processing and from there we’d be able to treat your child. Typical the phrasing then would be sensory processing disfunction or sensory processing deficit.

So sensory processing, what is it? Sensory processing disorder is when sensory signal is really not detected or do not get organized to elicit an appropriate response. Crystal is going to go into more further detail and tell us how sensory processing affects the body.

Alright, so how does sensory processing affect the body? So when you’re thinking of sensory processing, you think of your senses, how the input goes into your body, you touch something, you feel it. So what we’re going to do is talk about our 5 senses that everyone typically knows about and we’re also going to address 2 more that typically isn’t talked about.

Alright so the first one that we’re going to talk about today is auditory. When you think of auditory you typically think of hearing, listening. And that’s true, it goes into a lot of aspects or concepts of that and typically with a child with auditory defensiveness like crowded spaces, they can’t really focus because it’s so loud. Or maybe they’re very distressed when they hear harsh sounds, or typical sounds like lawn mower or dishwasher, it really bothers them, they’re not able to concentrate.

Or, they don’t hear loud sounds like a fire alarm going off or even notice it, that’s also a sign of sensory processing. Alright, that’s auditory, the next one is taste or oral. When you think of your mouth, you think of all the different taste, sour, sweet, and that’s true, there’s also how much can you feel in your mouth. Is there a lot of food and sometimes they’ll over stuff their mouth with food because they can’t feel what’s in it.

It could be that they lick random objects, or they really like intense flavors like a lot of salt, or sweetness, or they suck on lemons or limes. So that’s auditory and oral or mouth, the next one is olfactory or smell. And with this it could be that they’re very sensitive to a lot of smells that we typically don’t notice. Or it could be that the smell of something like boiled eggs, they wouldn’t even be able to be in the room, it’s way too strong for them. And this happens a lot with food, if something has a strong smell they just don’t even want to eat it because it’s so strong. So that’s auditory, oral, and your olfactory.

The next one is your vision, when you think of vision it’s just seeing things, which is true and it also could be also that the space is really crowded so they can’t really focus because there’s so much going on and they need to look all around. Also could be bright lights really bother them and they prefer dim lighting or maybe they really like the bright lights, it really keeps them alert or aroused. Or they like to watch objects spin, or different things move like watching fish tanks or really bright colors. So after that is vision, auditory, olfactory, hearing, and now we’re going to go on to touch or tactile.

When you think of that you think of the way things feel. This we notice a lot we see a lot with kids, talking about clothes textures, they don’t really like the seams in their clothes, or tags or zippers how they’re cold could be the temperature of items or the temperature of food even because your mouth is lined with skin so it goes with that whole tactile system. Another one could be they don’t like certain textures, they don’t like being wet or dirty and become very distressed about it. Or, they really like soft objects, they touch everything in the store.

So those are your 5 typical senses that everyone knows about, now we’re going to go onto proprioception and vestibular. When you think of proprioception, it’s your body and your concept of it, discriminating your right from your left and knowing the difference between the two. It also is body awareness. A lot of times these kids are described as clumsy, the mom would come in and say my kid is so clumsy! And that typically is a proprioception deficit. Or they crash into items, they move a lot and constantly falling or doing something to get that input into their muscles and their joints because they just don’t have it. Or they’re just hanging out and they’re very low, they don’t have, they need the input to get going, to become alert.

And the last one we’re going to talk about is vestibular, and that’s your body’s postural responses, sitting up nice and straight against gravity. So gravity pulls you to the ground and your body has to resist it. And that’s vestibular, so a lot of these kids will be in constant motion, they like to jump, they like to spin, they want to move a whole bunch. And that’s vestibular and proprioception, those are the ones you typically don’t hear about and a lot of kids really do seek that movement opportunity from those.

Now Kelsey’s going to give you a demonstration because it’s very confusing with all these terminologies. So our sensory system works as follows. You detect a sensory stimulus so it could be an auditory stimulus, visual, tactile or oral or vestibular proprioception. And what it does is our brain, or sensory system will process the response, organize the response, and understand the response, in order for our body to elicit a response. What we typically want to see is an appropriate response elicited, but for kids who struggle with sensory issues they usually don’t organize and understand sensory stimulus as it’s processed so they don’t elicit appropriate responses.

What Kelsey means by an appropriate response is if I get hit, I realize that’s an input. I’m like ohh, ok, that hurt, but I’m not going to yell, maybe Kelsey didn’t mean to hit me. But sometimes kids go ohh oww, why did you touch me, you shouldn’t have touched me, they become so distressed, that’s an inappropriate response. Even after multiple times queuing them they just can’t even function and become so overwhelmed with that one input that they can’t focus anymore.

Another one would be if there’s a lot of noise all of a sudden, they might cover their ears and might start screaming and be like what happened what happened what happened! Or start freaking out because their sensory system is unable to process into an appropriate response. Which would normally just be you jump a little bit and you’re scared but then you go about your business.

So my visual is going to be simulated in a traffic jam. This is going to be our demonstration of how your sensory system works. So the first demonstration is going to be about a typical person who can respond to sensory stimulus in an appropriate fashion. So let’s say we’re going to a movie premier and you walk into the movie theater and it’s crowded and it takes you by surprise but that sensory stimulus is able to be understood and organized in an appropriate fashion. So the traffic moves smoothly and you elicit an appropriate response. As you’re walking through the crowded space of the movie theater you might get bumped into 2 or 3 times and it might take you by surprise but you’re able to respond to that sensory stimulus and organize it and you keep going. The next thing, you’re going to walk into the movie theater and you hear the crunching of the popcorn the opening of the candy bags, the previews are on the movie screen, people talking, so it’s a lot to take in. But your sensory system is able to organize each of those senses appropriately and traffic is able to keep moving in a smooth manner, and you’re able to elicit an appropriate response. Well the movie starts playing, the lights get dim and the screen gets super bright, and the music and previews get super loud, again, that’s all different types of sensory stimulus, but your body is able to organize it in an appropriate way and you’re able to sit and enjoy the movie.

So the next example is of a child or adolescent who might struggle with sensory processing disorder or dysfunction. So they walk into the movie theater and they see that it’s crowded. Well as they’re walking in, they take in that sensory stimuli and they are unable to process it in an organized fashion. So what it does is causes a traffic jam. Their body isn’t able to respond to it appropriately so it just sits there. The next thing, they might get bumped into by a couple of people. Well to someone who’s able to respond to that appropriately it wouldn’t phase them but this person it causes them to again, have a traffic jam. They are unable to organize a response in an appropriate way, so it builds up. And it stays in their sensory system. The next thing, they walk into a movie theater and see that everyone is on their cell phones and they’re talking and crunching on the popcorn or sipping on their pop and eating their candy, well all those sensory stimuli, their sensory processing is not able to elicit an appropriate response so it gets stuck in that traffic jam. Well the movie starts to play, the lights get dim and the music gets super loud, again all those sensory stimuli coming in but they’re not able to get organized. So what is causes is this build up of sensory information that their body doesn’t know how to deal with properly. And what it causes is what we say is a sensory overload which causes them to break down and have a temper tantrum and get anxious and they just don’t know how to respond to these sensory stimuli appropriately so they’re unable to sit and watch the movie and enjoy the experience.

So this is our demonstration of sensory processing disorder and dysfunction. I hope this really helped you guys better understand what sensory processing is. If you think that your child might benefit from an occupational therapy evaluation, you’re more than welcome to get a referral from your doctor and come see us at Therapy Playground. We’d be happy to do an evaluation on your child. If you’d like further information please visit the website that is going to be linked below on this video and I hope you guys have a great day! Thank you.